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BACKGROUND: AI models have shown promise in performing many medical imaging tasks. However, our ability to explain what signals these models have learned is severely lacking. Explanations are needed in order to increase the trust of doctors in AI-based models, especially in domains where AI prediction capabilities surpass those of humans. Moreover, such explanations could enable novel scientific discovery by uncovering signals in the data that aren't yet known to experts. METHODS: In this paper, we present a workflow for generating hypotheses to understand which visual signals in images are correlated with a classification model's predictions for a given task. This approach leverages an automatic visual explanation algorithm followed by interdisciplinary expert review. We propose the following 4 steps: (i) Train a classifier to perform a given task to assess whether the imagery indeed contains signals relevant to the task; (ii) Train a StyleGAN-based image generator with an architecture that enables guidance by the classifier ("StylEx"); (iii) Automatically detect, extract, and visualize the top visual attributes that the classifier is sensitive towards. For visualization, we independently modify each of these attributes to generate counterfactual visualizations for a set of images (i.e., what the image would look like with the attribute increased or decreased); (iv) Formulate hypotheses for the underlying mechanisms, to stimulate future research. Specifically, present the discovered attributes and corresponding counterfactual visualizations to an interdisciplinary panel of experts so that hypotheses can account for social and structural determinants of health (e.g., whether the attributes correspond to known patho-physiological or socio-cultural phenomena, or could be novel discoveries). FINDINGS: To demonstrate the broad applicability of our approach, we present results on eight prediction tasks across three medical imaging modalities-retinal fundus photographs, external eye photographs, and chest radiographs. We showcase examples where many of the automatically-learned attributes clearly capture clinically known features (e.g., types of cataract, enlarged heart), and demonstrate automatically-learned confounders that arise from factors beyond physiological mechanisms (e.g., chest X-ray underexposure is correlated with the classifier predicting abnormality, and eye makeup is correlated with the classifier predicting low hemoglobin levels). We further show that our method reveals a number of physiologically plausible, previously-unknown attributes based on the literature (e.g., differences in the fundus associated with self-reported sex, which were previously unknown). INTERPRETATION: Our approach enables hypotheses generation via attribute visualizations and has the potential to enable researchers to better understand, improve their assessment, and extract new knowledge from AI-based models, as well as debug and design better datasets. Though not designed to infer causality, importantly, we highlight that attributes generated by our framework can capture phenomena beyond physiology or pathophysiology, reflecting the real world nature of healthcare delivery and socio-cultural factors, and hence interdisciplinary perspectives are critical in these investigations. Finally, we will release code to help researchers train their own StylEx models and analyze their predictive tasks of interest, and use the methodology presented in this paper for responsible interpretation of the revealed attributes. FUNDING: Google.
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Algoritmos , Catarata , Humanos , Cardiomegalia , Fundo de Olho , Inteligência ArtificialRESUMO
Deep learning algorithms have demonstrated remarkable potential in clinical diagnostics, particularly in the field of medical imaging. In this study, we investigated the application of deep learning models in early detection of fetal kidney anomalies. To provide an enhanced interpretation of those models' predictions, we proposed an adapted two-class representation and developed a multi-class model interpretation approach for problems with more than two labels and variable hierarchical grouping of labels. Additionally, we employed the explainable AI (XAI) visualization tools Grad-CAM and HiResCAM, to gain insights into model predictions and identify reasons for misclassifications. The study dataset consisted of 969 ultrasound images from unique patients; 646 control images and 323 cases of kidney anomalies, including 259 cases of unilateral urinary tract dilation and 64 cases of unilateral multicystic dysplastic kidney. The best performing model achieved a cross-validated area under the ROC curve of 91.28% ± 0.52%, with an overall accuracy of 84.03% ± 0.76%, sensitivity of 77.39% ± 1.99%, and specificity of 87.35% ± 1.28%. Our findings emphasize the potential of deep learning models in predicting kidney anomalies from limited prenatal ultrasound imagery. The proposed adaptations in model representation and interpretation represent a novel solution to multi-class prediction problems.
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Aprendizado Profundo , Nefropatias , Sistema Urinário , Gravidez , Feminino , Humanos , Ultrassonografia Pré-Natal/métodos , Diagnóstico Pré-Natal/métodos , Nefropatias/diagnóstico por imagem , Sistema Urinário/anormalidadesRESUMO
Background: The effect of surgery on advanced prostate cancer (PC) is unclear and predictive model for postoperative survival is lacking yet. Methods: We investigate the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, to collect clinical features of advanced PC patients. According to clinical experience, age, race, grade, pathology, T, N, M, stage, size, regional nodes positive, regional nodes examined, surgery, radiotherapy, chemotherapy, history of malignancy, clinical Gleason score (composed of needle core biopsy or transurethral resection of the prostate specimens), pathological Gleason score (composed of prostatectomy specimens) and prostate-specific antigen (PSA) are the potential predictive variables. All samples are divided into train cohort (70% of total, for model training) and test cohort (30% of total, for model validation) by random sampling. We then develop neural network to predict advanced PC patients' overall. Area under receiver operating characteristic curve (AUC) is used to evaluate model's performance. Results: 6380 patients, diagnosed with advanced (stage III-IV) prostate cancer and receiving surgery, have been included. The model using all collected clinical features as predictors and based on neural network algorithm performs best, which scores 0.7058 AUC (95% CIs, 0.7021-0.7068) in train cohort and 0.6925 AUC (95% CIs, 0.6906-0.6956) in test cohort. We then package it into a Windows 64-bit software. Conclusion: Patients with advanced prostate cancer may benefit from surgery. In order to forecast their overall survival, we first build a clinical features-based prognostic model. This model is accuracy and may offer some reference on clinical decision making.
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Neoplasias da Próstata , Ressecção Transuretral da Próstata , Masculino , Humanos , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/patologia , Prognóstico , Biópsia com Agulha de Grande Calibre , Redes Neurais de ComputaçãoRESUMO
BACKGROUND: This research focused on the development of a motor imagery (MI) based brain-machine interface (BMI) using deep learning algorithms to control a lower-limb robotic exoskeleton. The study aimed to overcome the limitations of traditional BMI approaches by leveraging the advantages of deep learning, such as automated feature extraction and transfer learning. The experimental protocol to evaluate the BMI was designed as asynchronous, allowing subjects to perform mental tasks at their own will. METHODS: A total of five healthy able-bodied subjects were enrolled in this study to participate in a series of experimental sessions. The brain signals from two of these sessions were used to develop a generic deep learning model through transfer learning. Subsequently, this model was fine-tuned during the remaining sessions and subjected to evaluation. Three distinct deep learning approaches were compared: one that did not undergo fine-tuning, another that fine-tuned all layers of the model, and a third one that fine-tuned only the last three layers. The evaluation phase involved the exclusive closed-loop control of the exoskeleton device by the participants' neural activity using the second deep learning approach for the decoding. RESULTS: The three deep learning approaches were assessed in comparison to an approach based on spatial features that was trained for each subject and experimental session, demonstrating their superior performance. Interestingly, the deep learning approach without fine-tuning achieved comparable performance to the features-based approach, indicating that a generic model trained on data from different individuals and previous sessions can yield similar efficacy. Among the three deep learning approaches compared, fine-tuning all layer weights demonstrated the highest performance. CONCLUSION: This research represents an initial stride toward future calibration-free methods. Despite the efforts to diminish calibration time by leveraging data from other subjects, complete elimination proved unattainable. The study's discoveries hold notable significance for advancing calibration-free approaches, offering the promise of minimizing the need for training trials. Furthermore, the experimental evaluation protocol employed in this study aimed to replicate real-life scenarios, granting participants a higher degree of autonomy in decision-making regarding actions such as walking or stopping gait.
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Interfaces Cérebro-Computador , Aprendizado Profundo , Exoesqueleto Energizado , Humanos , Algoritmos , Extremidade Inferior , Eletroencefalografia/métodosRESUMO
BACKGROUND: Accurately identifying drug-target interaction (DTI), affinity (DTA), and binding sites (DTS) is crucial for drug screening, repositioning, and design, as well as for understanding the functions of target. Although there are a few online platforms based on deep learning for drug-target interaction, affinity, and binding sites identification, there is currently no integrated online platforms for all three aspects. RESULTS: Our solution, the novel integrated online platform Drug-Online, has been developed to facilitate drug screening, target identification, and understanding the functions of target in a progressive manner of "interaction-affinity-binding sites". Drug-Online platform consists of three parts: the first part uses the drug-target interaction identification method MGraphDTA, based on graph neural networks (GNN) and convolutional neural networks (CNN), to identify whether there is a drug-target interaction. If an interaction is identified, the second part employs the drug-target affinity identification method MMDTA, also based on GNN and CNN, to calculate the strength of drug-target interaction, i.e., affinity. Finally, the third part identifies drug-target binding sites, i.e., pockets. The method pt-lm-gnn used in this part is also based on GNN. CONCLUSIONS: Drug-Online is a reliable online platform that integrates drug-target interaction, affinity, and binding sites identification. It is freely available via the Internet at http://39.106.7.26:8000/Drug-Online/ .
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Aprendizado Profundo , Interações Medicamentosas , Sítios de Ligação , Sistemas de Liberação de Medicamentos , Avaliação Pré-Clínica de MedicamentosRESUMO
Uyghur medicine is one of the four major ethnic medicines in China and is a component of traditional Chinese medicine. The intrinsic quality of Uyghur medicinal materials will directly affect the clinical efficacy of Uyghur medicinal preparations. However, in recent years, problems such as adulteration of Uyghur medicinal materials and foreign bodies with the same name still exist, so it is necessary to strengthen the quality control of Uyghur medicines to guarantee Uyghur medicinal efficacy. Identifying the components of Uyghur medicines can clarify the types of medicinal materials used, is a crucial step to realizing the quality control of Uyghur medicines, and is also an important step in screening the effective components of Uyghur medicines. Currently, the method of identifying the components of Uyghur medicines relies on manual detection, which has the problems of high toxicity of the unfolding agent, poor stability, high cost, low efficiency, etc. Therefore, this paper proposes a method based on Raman spectroscopy and multi-label deep learning model to construct a model Mix2Com for accurate identification of Uyghur medicine components. The experiments use computer-simulated mixtures as the dataset, introduce the Long Short-Term Memory Model (LSTM) and Attention mechanism to encode the Raman spectral data, use multiple parallel networks for decoding, and ultimately realize the macro parallel prediction of medicine components. The results show that the model is trained to achieve 90.76% accuracy, 99.41% precision, 95.42% recall value and 97.37% F1 score. Compared to the traditional XGBoost model, the method proposed in the experiment improves the accuracy by 49% and the recall value by 18%; compared with the DeepRaman model, the accuracy is improved by 9% and the recall value is improved by 14%. The method proposed in this paper provides a new solution for the accurate identification of Uyghur medicinal components. It helps to improve the quality standard of Uyghur medicinal materials, advance the research on screening of effective chemical components of Uyghur medicines and their action mechanisms, and then promote the modernization and development of Uyghur medicine.
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Medicina Tradicional do Leste Asiático , Análise Espectral Raman , Análise Espectral Raman/métodosRESUMO
Injuries caused by overuse are common in long-distance runners, and early detection of overuse-induced injuries can assist coaches in adjusting training programs to avoid further development of injuries and effectively prevent serious injuries. Gait research is an important tool in distance running research, through the athlete's gait parameters can obtain the athlete's movement status and injury. However, the traditional less research requires rich experience guidance, which is not conducive to widespread promotion. In this paper, deep learning technology is utilized to construct an athlete overuse injury gait detection model. Through the automatic analysis of the athletes less parameters to detect whether there is overuse-induced injury, early detection of injury trends, to avoid injury aggravation. Through experiments, it is verified that the model can effectively identify the gait parameter characteristics of overuse injury in excellent athletes. (AU)
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Humanos , Aprendizado Profundo , Análise da Marcha , Ferimentos e Lesões , Uso Excessivo de Medicamentos Prescritos , AtletasRESUMO
BACKGROUND: Radiotherapy (RT) is an important treatment modality for patients with brain malignancies. Traditionally, computed tomography (CT) images are used for RT treatment planning whereas magnetic resonance imaging (MRI) images are used for tumor delineation. Therefore, MRI and CT need to be registered, which is an error prone process. The purpose of this clinical study is to investigate the clinical feasibility of a deep learning-based MRI-only workflow for brain radiotherapy, that eliminates the registration uncertainty through calculation of a synthetic CT (sCT) from MRI data. METHODS: A total of 54 patients with an indication for radiation treatment of the brain and stereotactic mask immobilization will be recruited. All study patients will receive standard therapy and imaging including both CT and MRI. All patients will receive dedicated RT-MRI scans in treatment position. An sCT will be reconstructed from an acquired MRI DIXON-sequence using a commercially available deep learning solution on which subsequent radiotherapy planning will be performed. Through multiple quality assurance (QA) measures and reviews during the course of the study, the feasibility of an MRI-only workflow and comparative parameters between sCT and standard CT workflow will be investigated holistically. These QA measures include feasibility and quality of image guidance (IGRT) at the linear accelerator using sCT derived digitally reconstructed radiographs in addition to potential dosimetric deviations between the CT and sCT plan. The aim of this clinical study is to establish a brain MRI-only workflow as well as to identify risks and QA mechanisms to ensure a safe integration of deep learning-based sCT into radiotherapy planning and delivery. DISCUSSION: Compared to CT, MRI offers a superior soft tissue contrast without additional radiation dose to the patients. However, up to now, even though the dosimetrical equivalence of CT and sCT has been shown in several retrospective studies, MRI-only workflows have still not been widely adopted. The present study aims to determine feasibility and safety of deep learning-based MRI-only radiotherapy in a holistic manner incorporating the whole radiotherapy workflow. TRIAL REGISTRATION: NCT06106997.
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Neoplasias Encefálicas , Aprendizado Profundo , Radioterapia de Intensidade Modulada , Humanos , Estudos de Viabilidade , Estudos Retrospectivos , Radioterapia de Intensidade Modulada/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Dosagem Radioterapêutica , Imageamento por Ressonância Magnética/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/radioterapia , Encéfalo/diagnóstico por imagemRESUMO
Alternaria solani is the second most devastating foliar pathogen of potato crops worldwide, causing premature defoliation of the plants. This disease is currently prevented through the regular application of detrimental crop protection products and is guided by early warnings based on weather predictions and visual observations by farmers. To reduce the use of crop protection products, without additional production losses, it would be beneficial to be able to automatically detect Alternaria solani in potato fields. In recent years, the potential of deep learning in precision agriculture is receiving increasing research attention. Convolutional Neural Networks (CNNs) are currently the state of the art, but also come with challenges, especially regarding in-field robustness. This stems from the fact that they are often trained on datasets that are limited in size or have been recorded in controlled environments, not necessarily representative of real-world settings. We collected a dataset consisting of ultra-high-resolution modified RGB UAV-imagery of both symptomatic and non-symptomatic potato crops in the field during various years and disease stages to cover the great variability in agricultural data. We developed a convolutional neural network to perform in-field detection of Alternaria, defined as a binary classification problem. Our model achieves a similar accuracy as several state-of-the-art models for disease detection, but has a much lower inference time, which enhances its practical applicability. By using training data of three consecutive growing seasons (2019, 2020 and 2021) and test data of an independent fourth year (2022), an F1 score of 0.93 is achieved. Furthermore, we evaluate how different properties of the dataset such as its size and class imbalance impact the obtained accuracy.
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The broad adoption of electronic health record (EHR) systems brings us a tremendous amount of clinical data and thus provides opportunities to conduct data-based healthcare research to solve various clinical problems in the medical domain. Machine learning and deep learning methods are widely used in the medical informatics and healthcare domain due to their power to mine insights from raw data. When adapting deep learning models for EHR data, it is essential to consider its heterogeneous nature: EHR contains patient records from various sources including medical tests (e.g. blood test, microbiology test), medical imaging, diagnosis, medications, procedures, clinical notes, etc. Those modalities together provide a holistic view of patient health status and complement each other. Therefore, combining data from multiple modalities that are intrinsically different is challenging but intuitively promising in deep learning for EHR. To assess the expectations of multimodal data, we introduce a comprehensive fusion framework designed to integrate temporal variables, medical images, and clinical notes in EHR for enhanced performance in clinical risk prediction. Early, joint, and late fusion strategies are employed to combine data from various modalities effectively. We test the model with three predictive tasks: in-hospital mortality, long length of stay, and 30-day readmission. Experimental results show that multimodal models outperform uni-modal models in the tasks involved. Additionally, by training models with different input modality combinations, we calculate the Shapley value for each modality to quantify their contribution to multimodal performance. It is shown that temporal variables tend to be more helpful than CXR images and clinical notes in the three explored predictive tasks.
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The application of Artificial Intelligence (AI) to screen drug molecules with potential therapeutic effects has revolutionized the drug discovery process, with significantly lower economic cost and time consumption than the traditional drug discovery pipeline. With the great power of AI, it is possible to rapidly search the vast chemical space for potential drug-target interactions (DTIs) between candidate drug molecules and disease protein targets. However, only a small proportion of molecules have labelled DTIs, consequently limiting the performance of AI-based drug screening. To solve this problem, a machine learning-based approach with great ability to generalize DTI prediction across molecules is desirable. Many existing machine learning approaches for DTI identification failed to exploit the full information with respect to the topological structures of candidate molecules. To develop a better approach for DTI prediction, we propose GraphormerDTI, which employs the powerful Graph Transformer neural network to model molecular structures. GraphormerDTI embeds molecular graphs into vector-format representations through iterative Transformer-based message passing, which encodes molecules' structural characteristics by node centrality encoding, node spatial encoding and edge encoding. With a strong structural inductive bias, the proposed GraphormerDTI approach can effectively infer informative representations for out-of-sample molecules and as such, it is capable of predicting DTIs across molecules with an exceptional performance. GraphormerDTI integrates the Graph Transformer neural network with a 1-dimensional Convolutional Neural Network (1D-CNN) to extract the drugs' and target proteins' representations and leverages an attention mechanism to model the interactions between them. To examine GraphormerDTI's performance for DTI prediction, we conduct experiments on three benchmark datasets, where GraphormerDTI achieves a superior performance than five state-of-the-art baselines for out-of-molecule DTI prediction, including GNN-CPI, GNN-PT, DeepEmbedding-DTI, MolTrans and HyperAttentionDTI, and is on a par with the best baseline for transductive DTI prediction. The source codes and datasets are publicly accessible at https://github.com/mengmeng34/GraphormerDTI.
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Inteligência Artificial , Descoberta de Drogas , Avaliação Pré-Clínica de Medicamentos , Redes Neurais de Computação , BenchmarkingRESUMO
While neurological manifestations are core features of Fabry disease (FD), quantitative neuroimaging biomarkers allowing to measure brain involvement are lacking. We used deep learning and the brain-age paradigm to assess whether FD patients' brains appear older than normal and to validate brain-predicted age difference (brain-PAD) as a possible disease severity biomarker. MRI scans of FD patients and healthy controls (HCs) from a single Institution were, retrospectively, studied. The Fabry stabilization index (FASTEX) was recorded as a measure of disease severity. Using minimally preprocessed 3D T1-weighted brain scans of healthy subjects from eight publicly available sources (N = 2160; mean age = 33 years [range 4-86]), we trained a model predicting chronological age based on a DenseNet architecture and used it to generate brain-age predictions in the internal cohort. Within a linear modeling framework, brain-PAD was tested for age/sex-adjusted associations with diagnostic group (FD vs. HC), FASTEX score, and both global and voxel-level neuroimaging measures. We studied 52 FD patients (40.6 ± 12.6 years; 28F) and 58 HC (38.4 ± 13.4 years; 28F). The brain-age model achieved accurate out-of-sample performance (mean absolute error = 4.01 years, R2 = .90). FD patients had significantly higher brain-PAD than HC (estimated marginal means: 3.1 vs. -0.1, p = .01). Brain-PAD was associated with FASTEX score (B = 0.10, p = .02), brain parenchymal fraction (B = -153.50, p = .001), white matter hyperintensities load (B = 0.85, p = .01), and tissue volume reduction throughout the brain. We demonstrated that FD patients' brains appear older than normal. Brain-PAD correlates with FD-related multi-organ damage and is influenced by both global brain volume and white matter hyperintensities, offering a comprehensive biomarker of (neurological) disease severity.
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Aprendizado Profundo , Doença de Fabry , Leucoaraiose , Humanos , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Fabry/diagnóstico por imagem , Estudos Retrospectivos , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética , BiomarcadoresRESUMO
Cardiovascular diseases (CVD) are a leading cause of death globally, and result in significant morbidity and reduced quality of life. The electrocardiogram (ECG) plays a crucial role in CVD diagnosis, prognosis, and prevention; however, different challenges still remain, such as an increasing unmet demand for skilled cardiologists capable of accurately interpreting ECG. This leads to higher workload and potential diagnostic inaccuracies. Data-driven approaches, such as machine learning (ML) and deep learning (DL) have emerged to improve existing computer-assisted solutions and enhance physicians' ECG interpretation of the complex mechanisms underlying CVD. However, many ML and DL models used to detect ECG-based CVD suffer from a lack of explainability, bias, as well as ethical, legal, and societal implications (ELSI). Despite the critical importance of these Trustworthy Artificial Intelligence (AI) aspects, there is a lack of comprehensive literature reviews that examine the current trends in ECG-based solutions for CVD diagnosis or prognosis that use ML and DL models and address the Trustworthy AI requirements. This review aims to bridge this knowledge gap by providing a systematic review to undertake a holistic analysis across multiple dimensions of these data-driven models such as type of CVD addressed, dataset characteristics, data input modalities, ML and DL algorithms (with a focus on DL), and aspects of Trustworthy AI like explainability, bias and ethical considerations. Additionally, within the analyzed dimensions, various challenges are identified. To these, we provide concrete recommendations, equipping other researchers with valuable insights to understand the current state of the field comprehensively.
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Doenças Cardiovasculares , Humanos , Doenças Cardiovasculares/diagnóstico , Inteligência Artificial , Qualidade de Vida , Eletrocardiografia , Aprendizado de MáquinaRESUMO
Accurately predicting the binding affinity between proteins and ligands is crucial in drug screening and optimization, but it is still a challenge in computer-aided drug design. The recent success of AlphaFold2 in predicting protein structures has brought new hope for deep learning (DL) models to accurately predict protein-ligand binding affinity. However, the current DL models still face limitations due to the low-quality database, inaccurate input representation and inappropriate model architecture. In this work, we review the computational methods, specifically DL-based models, used to predict protein-ligand binding affinity. We start with a brief introduction to protein-ligand binding affinity and the traditional computational methods used to calculate them. We then introduce the basic principles of DL models for predicting protein-ligand binding affinity. Next, we review the commonly used databases, input representations and DL models in this field. Finally, we discuss the potential challenges and future work in accurately predicting protein-ligand binding affinity via DL models.
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Aprendizado Profundo , Ligantes , Bases de Dados Factuais , Desenho de Fármacos , Avaliação Pré-Clínica de MedicamentosRESUMO
OBJECTIVES: Metabolic disease in children is increasing worldwide and predisposes a wide array of chronic comorbid conditions with severe impacts on quality of life. Tools for early detection are needed to promptly intervene to prevent or slow the development of these long-term complications. MATERIALS AND METHODS: No clinically available tools are currently in widespread use that can predict the onset of metabolic diseases in pediatric patients. Here, we use interpretable deep learning, leveraging longitudinal clinical measurements, demographical data, and diagnosis codes from electronic health record data from a large integrated health system to predict the onset of prediabetes, type 2 diabetes (T2D), and metabolic syndrome in pediatric cohorts. RESULTS: The cohort included 49 517 children with overweight or obesity aged 2-18 (54.9% male, 73% Caucasian), with a median follow-up time of 7.5 years and mean body mass index (BMI) percentile of 88.6%. Our model demonstrated area under receiver operating characteristic curve (AUC) accuracies up to 0.87, 0.79, and 0.79 for predicting T2D, metabolic syndrome, and prediabetes, respectively. Whereas most risk calculators use only recently available data, incorporating longitudinal data improved AUCs by 13.04%, 11.48%, and 11.67% for T2D, syndrome, and prediabetes, respectively, versus models using the most recent BMI (P < 2.2 × 10-16). DISCUSSION: Despite most risk calculators using only the most recent data, incorporating longitudinal data improved the model accuracies because utilizing trajectories provides a more comprehensive characterization of the patient's health history. Our interpretable model indicated that BMI trajectories were consistently identified as one of the most influential features for prediction, highlighting the advantages of incorporating longitudinal data when available.
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Aprendizado Profundo , Diabetes Mellitus Tipo 2 , Síndrome Metabólica , Estado Pré-Diabético , Humanos , Criança , Adolescente , Masculino , Feminino , Estado Pré-Diabético/diagnóstico , Síndrome Metabólica/diagnóstico , Pré-Escolar , Registros Eletrônicos de Saúde , Curva ROC , Doenças Metabólicas/diagnóstico , Obesidade Infantil , Área Sob a CurvaRESUMO
Radiotherapy commonly utilizes cone beam computed tomography (CBCT) for patient positioning and treatment monitoring. CBCT is deemed to be secure for patients, making it suitable for the delivery of fractional doses. However, limitations such as a narrow field of view, beam hardening, scattered radiation artifacts, and variability in pixel intensity hinder the direct use of raw CBCT for dose recalculation during treatment. To address this issue, reliable correction techniques are necessary to remove artifacts and remap pixel intensity into Hounsfield Units (HU) values. This study proposes a deep-learning framework for calibrating CBCT images acquired with narrow field of view (FOV) systems and demonstrates its potential use in proton treatment planning updates. Cycle-consistent generative adversarial networks (cGAN) processes raw CBCT to reduce scatter and remap HU. Monte Carlo simulation is used to generate CBCT scans, enabling the possibility to focus solely on the algorithm's ability to reduce artifacts and cupping effects without considering intra-patient longitudinal variability and producing a fair comparison between planning CT (pCT) and calibrated CBCT dosimetry. To showcase the viability of the approach using real-world data, experiments were also conducted using real CBCT. Tests were performed on a publicly available dataset of 40 patients who received ablative radiation therapy for pancreatic cancer. The simulated CBCT calibration led to a difference in proton dosimetry of less than 2%, compared to the planning CT. The potential toxicity effect on the organs at risk decreased from about 50% (uncalibrated) up the 2% (calibrated). The gamma pass rate at 3%/2 mm produced an improvement of about 37% in replicating the prescribed dose before and after calibration (53.78% vs 90.26%). Real data also confirmed this with slightly inferior performances for the same criteria (65.36% vs 87.20%). These results may confirm that generative artificial intelligence brings the use of narrow FOV CBCT scans incrementally closer to clinical translation in proton therapy planning updates.
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Prótons , Tomografia Computadorizada de Feixe Cônico Espiral , Humanos , Dosagem Radioterapêutica , Inteligência Artificial , Estudos de Viabilidade , Processamento de Imagem Assistida por Computador/métodosRESUMO
The primary purpose of this paper is to establish a healthcare ecosystem framework for COVID-19, CronaSona. Unlike some studies that focus solely on detection or forecasting, CronaSona aims to provide a holistic solution, for managing data and/or knowledge, incorporating detection, forecasting, expert advice, treatment recommendations, real-time tracking, and finally visualizing results. The innovation lies in creating a comprehensive healthcare ecosystem framework and an application that not only aids in COVID-19 diagnosis but also addresses broader health challenges. The main objective is to introduce a novel framework designed to simplify the development and construction of applications by standardizing essential components required for applications focused on addressing diseases. CronaSona includes two parts, which are stakeholders and shared components, and four subsystems: (1) the management information subsystem, (2) the expert subsystem, (3) the COVID-19 detection and forecasting subsystem, and (4) the mobile tracker subsystem. In the proposed framework, a CronaSona app. was built to try to put the virus under control. It is a reactive mobile application for all users, especially COVID-19 patients and doctors. It aims to provide a reliable diagnostic tool for COVID-19 using deep learning techniques, accelerating diagnosis and referral processes, and focuses on forecasting the transmission of COVID-19. It also includes a mobile tracker subsystem for monitoring potential carriers and minimizing the virus spread. It was built to compete with other applications and to help people face the COVID-19 virus. Upon receiving the proposed framework, an application was developed to validate and test the framework's functionalities. The main aim of the developed application, CronaSona app., is to develop and test a reliable diagnostic tool using deep learning techniques to avoid increasing the spread of the disease as much as possible and to accelerate the diagnosis and referral of patients by detecting COVID-19 features from their chest X-ray images. By using CronaSona, human health is saved and stress is reduced by knowing everything about the virus. It performs with the highest accuracy, F1-score, and precision, with consecutive values of 97%, 97.6%, and 96.6%.
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COVID-19 , SARS-CoV-2 , Humanos , Inteligência Artificial , COVID-19/diagnóstico , COVID-19/epidemiologia , Aprendizado Profundo , Atenção à Saúde , Previsões , Aplicativos MóveisRESUMO
Understanding how outdoor environments affect mental health outcomes is vital in today's fast-paced and urbanized society. Recently, advancements in data-gathering technologies and deep learning have facilitated the study of the relationship between the outdoor environment and human perception. In a systematic review, we investigate how deep learning techniques can shed light on a better understanding of the influence of outdoor environments on human perceptions and emotions, with an emphasis on mental health outcomes. We have systematically reviewed 40 articles published in SCOPUS and the Web of Science databases which were the published papers between 2016 and 2023. The study presents and utilizes a novel topic modeling method to identify coherent keywords. By extracting the top words of each research topic, and identifying the current topics, we indicate that current studies are classified into three areas. The first topic was "Urban Perception and Environmental Factors" where the studies aimed to evaluate perceptions and mental health outcomes. Within this topic, the studies were divided based on human emotions, mood, stress, and urban features impacts. The second topic was titled "Data Analysis and Urban Imagery in Modeling" which focused on refining deep learning techniques, data collection methods, and participants' variability to understand human perceptions more accurately. The last topic was named "Greenery and visual exposure in urban spaces" which focused on the impact of the amount and the exposure of green features on mental health and perceptions. Upon reviewing the papers, this study provides a guide for subsequent research to enhance the view of using deep learning techniques to understand how urban environments influence mental health. It also provides various suggestions that should be taken into account when planning outdoor spaces.
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Mineração de Dados , Aprendizado Profundo , Saúde Mental , Humanos , Mineração de Dados/métodos , Percepção , EmoçõesRESUMO
Objective. Classifying motor imagery (MI) tasks that involve fine motor control of the individual five fingers presents unique challenges when utilizing electroencephalography (EEG) data. In this paper, we systematically assess the classification of MI functions for the individual five fingers using single-trial time-domain EEG signals. This assessment encompasses both within-subject and cross-subject scenarios, supported by data-driven analysis that provides statistical validation of the neural correlate that could potentially discriminate between the five fingers.Approach. We present Shapley-informed augmentation, an informed approach to enhance within-subject classification accuracy. This method is rooted in insights gained from our data-driven analysis, which revealed inconsistent temporal features encoding the five fingers MI across sessions of the same subject. To evaluate its impact, we compare within-subject classification performance both before and after implementing this augmentation technique.Main results. Both the data-driven approach and the model explainability analysis revealed that the parietal cortex contains neural information that helps discriminate the individual five fingers' MI apart. Shapley-informed augmentation successfully improved classification accuracy in sessions severely affected by inconsistent temporal features. The accuracy for sessions impacted by inconsistency in their temporal features increased by an average of26.3%±6.70, thereby enabling a broader range of subjects to benefit from brain-computer interaction (BCI) applications involving five-fingers MI classification. Conversely, non-impacted sessions experienced only a negligible average accuracy decrease of2.01±5.44%. The average classification accuracy achieved is around 60.0% (within-session), 50.0% (within-subject) and 40.0% (leave-one-subject-out).Significance. This research offers data-driven evidence of neural correlates that could discriminate between the individual five fingers MI and introduces a novel Shapley-informed augmentation method to address temporal variability of features, ultimately contributing to the development of personalized systems.
Assuntos
Interfaces Cérebro-Computador , Imaginação , Humanos , Imagens, Psicoterapia , Dedos , Encéfalo , Eletroencefalografia/métodos , AlgoritmosRESUMO
The advancements in data acquisition, storage, and processing techniques have resulted in the rapid growth of heterogeneous medical data. Integrating radiological scans, histopathology images, and molecular information with clinical data is essential for developing a holistic understanding of the disease and optimizing treatment. The need for integrating data from multiple sources is further pronounced in complex diseases such as cancer for enabling precision medicine and personalized treatments. This work proposes Multimodal Integration of Oncology Data System (MINDS)-a flexible, scalable, and cost-effective metadata framework for efficiently fusing disparate data from public sources such as the Cancer Research Data Commons (CRDC) into an interconnected, patient-centric framework. MINDS consolidates over 41,000 cases from across repositories while achieving a high compression ratio relative to the 3.78 PB source data size. It offers sub-5-s query response times for interactive exploration. MINDS offers an interface for exploring relationships across data types and building cohorts for developing large-scale multimodal machine learning models. By harmonizing multimodal data, MINDS aims to potentially empower researchers with greater analytical ability to uncover diagnostic and prognostic insights and enable evidence-based personalized care. MINDS tracks granular end-to-end data provenance, ensuring reproducibility and transparency. The cloud-native architecture of MINDS can handle exponential data growth in a secure, cost-optimized manner while ensuring substantial storage optimization, replication avoidance, and dynamic access capabilities. Auto-scaling, access controls, and other mechanisms guarantee pipelines' scalability and security. MINDS overcomes the limitations of existing biomedical data silos via an interoperable metadata-driven approach that represents a pivotal step toward the future of oncology data integration.